5-year-old Audrey was born with her lungs connected to her stomach and an incomplete esophagus (Long Gap EA/TEF or Esophageal Atresia). After two big surgeries and 142 days in the NICU in Utah, Audrey finally moved home but has since needed much more surgery, now in Boston. Much of her food still comes through a tube directly into her stomach, and she has had many procedures to help her swallow food, but she is thriving today. Thank you for blessing us with your love and prayers.
Flutter By
Thursday, November 24, 2011
Happy Thanksgiving!
Wednesday, November 2, 2011
WONDERFUL news!
Friday, October 28, 2011
First Dilation
Thursday, October 27, 2011
Pressing Forward with Faith
Four and a half weeks home, and it seems like a blink. I've been avoiding the computer for the past two of them, reading my kids' library books and trying to figure out what to say in a blog post... but feeling pretty drained of artistic eloquence. There is so much to share, but a lot of it is just, well, mucking through the plain old hard work part of being home again with our other four kids, plus Audrey. We have ups and downs (and sometimes the downs and downs) of discouragement and feeling overwhelmed, and then there are these moments of sweetness and light where I just think, ok, this is worth it, and infinitely more.
Her first five days at home were pretty eventful. She and I slept most of the first two days, and oh she was a precious sight, sleeping in her little pink cloud of a bed beside my sunny bedroom window, right beside my bed. I could hardly leave her side. On the third day we took her to her first regular appointment with her new pediatrician. It was a huge production just to get her out the door, since we were still getting used to her gear and everything, and a busy doctor's office full of sick children was the last place I wanted to take her. We made it through that, and she came home to the happy welcome of her loving siblings, joined us for family dinner in her own high chair (even though she can't eat, she can watch! It's great therapy for her to watch her family eating-- it's something she's never seen, and I am convinced it will help her to get used to the idea that that's what mouths are for. It has worked! All that observation, plus teasing and relaxed play over the past month, has released her oral aversion to where she will finally open her mouth and put her own fingers in, a huge hooray!).
And then on her fifth night home, she got sick with a nasty head cold. Aside from the usual aches and stuffiness, it made her reflux much worse. When she refluxes, she suddenly gags, then chokes and sputters and gasps for breath while thick bubbles come out her mouth and nose. At the end of each episode, when she finally finishes wrestling with herself, she looks up at us and smiles wide as if to say, "I did it!" It normally happens about 10-15 times a day. That night alone she must have topped thirty. We set her an appointment to see her pediatrician again that afternoon—their earliest opening, and daddy took her to that while I took our oldest child to a much-anticipated broadway show in Salt Lake for an early birthday gift from grandma. I called after the show and learned that Audrey had been measured at the high 80s for her oxygen saturation, and that the doctor had said if she got any worse, to take her back up to the hospital. Audrey had been terrified in the doctor's office, and kept looking all around with a very worried expression and trembling, as if she knew they might not let her go back home. Up in Salt Lake, I was supposed to be enjoying myself with my oldest, but I could barely pull my mind away from worrying about Audrey. Would she have to go back to the hospital so soon after coming home at last? Was this what our life was going to be like from now on? In and out of the hospital, and back again on the turn of a dime? I had been blessed to be strong through so many challenges this summer, but when I thought of this I could hardly bear the thought. On the drive home, my oldest fell asleep in the car, and I had a few minutes alone with my thoughts. I felt more than ever the split life that I'd been living, away from my children, away from my husband, away from my parents in Oregon and my sweet grandmothers, one of whom has just lost her husband this summer. I missed them all so terribly. I knew that the hospital is a wonderful place, that they have taken incredible care of my baby, but I was so homesick for my family to be together. I thought about a beautiful dream I'd had that week, that had stuck with me profoundly--the Savior had come again to earth, and though I didn't see his return with my eyes, I had been filled with the peace and the joy of that sure knowledge, and then after a few moments, just a tinge of worry and wondering about whether I was prepared. Not long after, Christ came to my home to heal my baby, but in order to let him in, I was asked to recognize him out of a crowd. My eyes searched each of the faces, and finally rested on a man being held in the arms of his friends. I reached forward to take his hand, and the Savior “started from disguise.” I felt wrapped in love and so comforted in that moment, and when I awoke it was a different type of homesickness that left me filled with longing. Now, as I drove home from the city, seemingly halfway between so many worlds, tears filled my eyes as a song I'd never heard before played. It seemed like the echo of my heart, replete with so many meanings:
You're in a better place, I've heard a thousand times
And at least a thousand times I've rejoiced for you
But the reason why I'm broken, the reason why I cry
Is how long must I wait to be with you
I close my eyes and I see your face
If home's where my heart is then I'm out of place
Lord, won't you give me strength to make it through somehow
I've never been more homesick than now
Help me Lord cause I don't understand your ways
The reason why I wonder if I'll ever know
But, even if you showed me, the hurt would be the same
Cause I'm still here so far away from home
I close my eyes and I see your face
If home's where my heart is then I'm out of place
Lord, won't you give me strength to make it through somehow
I've never been more homesick than now
In Christ, there are no goodbyes
And in Christ, there is no end
So I'll hold onto Jesus with all that I have
To see you again
To see you again
And I close my eyes and I see your face
If home's where my heart is then I'm out of place
Lord, won't you give me strength to make it through somehow
Won't you give me strength to make it through somehow
Won't you give me strength to make it through somehow
I've never been more homesick than now
(“Homesick”, by Mercy Me)
Once again, that night I called upon our friends and family for prayers for Audrey, and by morning she had turned the corner toward being well again.
The next couple of weeks she steadily gained in strength and stamina until we eventually decided she was ready to make it out on some adventures. We took her on an exciting hike where she got to participate in the annual homecoming tradition of “lighting the Y” on the mountain at dusk.
We made it!
With Cosmo, the Cougar
We are still a bit clumsy with her G-tube-- it accidentally came out twice that first week, until we figured out that we needed to pin the tube to her diaper. Ever since then, she has leaked a fair amount whenever she puts any pressure on her stomach by laying or even resting on her tummy, but our trick has worked well and it has never come out again, but on the hike it had come undone from the tube and leaked all over, making her wet and hungry, so it wasn't as nice for her as we'd hoped, but she's been very patient with our learning curve. Our million-dollar baby also needed straight Neosporin on her poor little bum for the first couple of weeks, because apparently the simple switch from (hospital-only) liquid to (home) powdered formula (even though it was the same type, Nutramigen) was enough to give her the worst diaper rash we'd ever seen, a topical staph infection that refused to go away with anything but antibiotics. And six weeks later she still has a stubborn rash from the adhesive on the hospital monitor leads, that I am now treating like an eczema flareup, with success.
Her first followup visit to see Dr. Downey in his new practice, he evaluated her weight gain according to the growth chart and showed me how she had steadily climbed from the 45th percentile at birth to the 95th. He felt she was being overfed, and looking at her chubby rolls, then back at our other petite children, we totally agreed. He lowered her overall calories and since then I feel her reflux has improved, until the past few days. He ordered a swallow study to evaluate the way she is swallowing liquids, which is the first step toward oral feeds, and he advised us that once she does begin to take a little food by mouth, she will probably not take a bottle at all. She will probably take food only by a spoon, due to some differences in the way the mouth handles the two methods, but he did say that breastfeeding was different in his mind, and should still be fine as a creature comfort. We haven't been successful with non-nutritive feeding since being at home, but I have continued to pump milk for her in hopes that the antibodies will help her to fight off any viral infections the family may encounter.
So, last Friday we finally had a swallow study, her first fluoroscopy to see what the inside of her throat looks like when she swallows-- this study is the key to the question of whether she can protect her airways when she swallows, a requirement before she can be approved to try any eating by mouth. First, the doctor tried to give her the contrast (a liquid that shows up on the x ray) in a bottle, and while Audrey allowed her to put it in her mouth, she did not suck on it. Then they squeezed a little of the contrast into her mouth from a syringe. Audrey widened her eyes in surprise, she sputtered and panicked a little, but then swallowed! We now saw exactly what the problem is. It's exactly as Dr. Downey described, a wide normal-sized opening at the back of her throat, until it reaches the surgery site, ending abruptly in a tiny opening that leads down to her stomach, like a funnel. It was amazing, and heartbreaking at the same time--- I watched her struggle against her gag reflex, trying to keep it from coming back up as that pocket of liquid just sat halfway down her throat for several minutes, with tiny droplets trickling down toward her stomach a bit at a time. The doctor called Dr. Downey and he was able to stop by and see the results right there, and told me that he felt Audrey is ready for a series of dilations where they will gently widen that area in her throat a little bit at a time. He told me to let him know if she seemed to be getting worse, and that we would probably do the first dilation in about two weeks. As if on cue, over the weekend she seemed to get worse. The past several nights she has woken up multiple times sputtering and sneezing and coughing and gasping, fighting for breath-- and what she sneezes out isn't the thick green gunk of a headcold, but seems to be normal clear saliva. She isn't drooling, which would be the sign of a totally closed hole, so we've patiently waited as the hospitals and doctors have sorted out where she was going to have her first dilation. Soon she'll be able to have them down here in our hometown, but until Dr. Downey gets the instruments he wants down here, we'll have to travel up to Primary... starting bright and early tomorrow morning! Hopefully this will be the start of big improvements, since once she's able to swallow more completely, I hope she won't have to fight her own throat so much. Unfortunately there's also a good chance that her reflux may bring up more milk in the future, but we'll cross that bridge when we come to it, and on a good note we might get to try feeding her some tastes by mouth for the first time! At any rate, it has been a very busy time, and we are so grateful for the help of our friends and family and caregivers. My life is a little--ok, maybe a lot--insane, the bills don't stop flooding in, and it seems like our other kids have each had their own little medical dramas going on, but in the past month we've also seen the oral aversion subside dramatically, enjoyed some family fun time, and heard her precious first giggles. Through it all we have each other, and we just try to keep pressing forward with faith.
Sunday, September 18, 2011
Our NICU Slumber Party and Audrey's Big "Lawnch" Sunday, September 18
What a wild 'n craaazy slumber party we had! But life would be too boring if everything went according to plan, right? I should have taken it as a sign when very first thing I ran into another poor mom who had thought she was going home that day, had even bought balloons and then her baby had a tiny hiccup that kept them there for a few extra days, argh!..... and then, when we went to room in, the crib couldn't fit through the doorway of the private room and the nurses weren't sure what to do... finally they found someone who had been here when our other long-termer buddy Craig had gone home last week (biggest babies=biggest NICU cribs), who knew they had had to remove the corner bumpers with a screwdriver! hahahahah. We got somewhat settled in and all went swimmingly for a while. Usually Audrey goes to sleep around 9pm and it was at least that by the time we really got in there and were left to our own devices, and she was still wide awake so I pulled out our "Laughter Kit" which was a special good-bye gift from her hospital "Auntie" Robyn, and read her the book Tickle Monster then snuggled a bit, gave her her night meds, dressed her in her jammies and laid her down for bed. It was 10pm and we were all ready to switch to the home feeding pump, so the nurse came in to supervise and together we realized that despite all of the great demonstrations I had had of the many settings of this thing, the actual pump part did not work! It was crazy, we were on the phone with the 24 hour help line and they said the "Error 13" message we were getting was a mechanical failure that would require replacement, so we ended up using a hospital pump overnight after all and the nurse took care of it instead of me, it was so nice of her! But I felt guilty thinking, so much for hands on experience! (And good thing I'm not superstitious right? Error 13, hahaha! after all those uses of the word HOME.... that's why we say picnic instead!) Audrey normally sleeps through almost the whole night-- but she was very stimulated by the new room, and had two nasty diapers in the night, several refluxes and a ton of desats (we think it was just because her feet are so chubby and so active so it was getting a bad signal... ugh that stupid alarm kept BOTH of us awake all night!) Brooke was our night nurse, what a cutie and she was the primary nurse for our "predecessor" Sawyer! As she left she woefully said, "I hate to say this but this might keep you guys here longer!" My heart sank and it took a moment to register that she meant just a few hours longer if the replacement pump took a while to come. The loose frequent messy diapers didn't worry her, and we discussed lots of things about mixing the milk so that when Yvonne came on.... wonderful, magical, amazing Yvonne, everything went fine for the rest of the day, the new pump arrived and I got it figured out without a hitch, and sure enough, we were out of there and on the road by 3:45! Thank you and good bye for now, Primary Children's!! Audrey really took everything in stride, her siblings, the car ride, the outdoors, she snoozed half of the ride home, Gideon kept waving and cooing "hi!" to her from his carseat next to her, and tried several times to give her his sippy cup and favorite stuffed animal monkey. She woke up soon after we pulled in the driveway, and it was so hard to decide what to do first! We almost took her on a stroller ride, but everyone was hungry so we stayed home to fix something and I had to get her stuff set up, so we held off for the time being but did linger outside long enough to greet two of our friends who passed by, and it took us a moment to notice that she was staring, huge-eyed, at the ground by our feet as we stood on the lawn. She had never seen grass before.
Saturday, September 17, 2011
Facebook Status Update: Saturday, September 17
Tic Toc, Tic Toc, DINGALINGALING!!! Saturday, September 17
Getting her bed ready at home!!! She'll be right next to us. The pool noodle is to keep her in the centered position so her torso is elevated for preventing aspiration from reflux. |
Thank you Ashli!! |
Melissa and Colin meet Audrey |
Tired, tired momma. But so happy to be outside in the Angel Garden at last. |
Annnnnd, happy, happy news about her pancreas: this week she had a six-hour "fast" when they turned off her pump and checked her blood sugar every hour (poke poke! so sad, she got to cringing whenever the hall door would open around the hour mark!) but at the end, her readings were perfect! She passed with flying colors! And they said they think that scare is at last behind us. Our biggest challenge since ditching the TPN has been the refluxing. At least once a day she will suddenly start heaving and suddenly milk bubbles out her mouth and sometimes even her nose. It is always so scary to watch her struggle for breath as she works to swallow and sort out things in her throat! Her paralyzed vocal chord is hopefully in the process of healing so that she can protect her lungs from spit and reflux, and we are grateful that she hasn't had any further episodes of fluid in the lungs-- we also keep her torso elevated all the time which helps keep her airway clear. We have an appointment near the end of October to scope her throat again and see if her vocal chords are healed so that she can begin trying eating by mouth again. That will be the key to a lot of things, but the delayed timing will be good in a lot of ways. Currently, her oral aversion is so severe that she will not open her mouth for ANYthing except to yawn. She even cries with her mouth closed, and gags any time something begins to go past her lips... it is so sad to think that this has developed since her surgery, but it is one of the primary things I see opportunities to heal at home. One day about a week ago, I tried non nutritive breastfeeding for the first time in ages-- it was so sweet to see that she remembered how to root, and that she was frustrated with herself for not being able to open her mouth without starting to gag. She fell asleep in my arms nestled against my chest, and the next day Kiley was amazed to see that she was doing a lot better at not gagging as she stroked her lips with a lollipop. It has been kind of surreal managing the onslaught of upcoming doctor appointments and equipment training and emergency skills, but I think we are finally about there. It definitely feels like being about to give birth again, then patiently extricating my baby from the hospital while simultaneously feeling twinges of worry about my own abilities to handle her special needs. Months ago, there was a story shared in parent hour that has proved relevant time and time again. It was called “Welcome to Holland,” and I've shared it below. I hope that one day Audrey will be able to eat normally and manage her reflux safely, I hope that her G tube will some day soon be a thing of the past, I hope that one day she will be running around normally with faded scars eating mac n cheese. But I will never, never forget what it is like to know that my baby is different. She is now almost sixteen pounds, and 142 days old, and tomorrow she will leave the hospital for the first time. That should make me happy, and of course it does! ...but in another sense I grieve. I will look at those tiny clothes that were supposed to be hers, that I had saved for her from my first baby and some even from my own babyhood, that she will never wear, and I will feel a little sad. But then I will look at this beautiful, strong, happy child who has been through so much, and I will remember that so many babies have it so much harder, and I will thank my lucky stars—and my amazing God who has cradled us through it all—for the blessings that we have. Family and friends, nurses and doctors, therapists and helpers of every flavor, you have been our angels. Here's to team Audrey and the adventures yet to come!
WELCOME TO HOLLAND
Emily Perl Kingsley.
I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this......
When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.
After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."
"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."
But there's been a change in the flight plan. They've landed in Holland and there you must stay.
The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.
So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.
It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts.
But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."
And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.
But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.
Friday, September 16, 2011
Friday, September 16
Tuesday, September 13, 2011
Tuesday, September 13
All a-flutter with excitement for the new release coming out this Sunday!!!! "Audrey: Unplugged." ♥ ♥ ♥
AUDREY IS COMING HOME THIS SUNDAY!!!!!!!!!!! But at the NICU, a baby's health can change so quickly, there are sometimes hiccups in those plans that extend a stay past the hoped-for discharge date. So there is a cute superstition about the word "Home" jinxing things... instead we say "picnic."
Our family went up for an evening visit to see Audrey, and had a very sweet time all together out on the patio in the dark, with our sweet primary night nurse Ashli!
Thursday, September 8, 2011
Rain on my Picnic
After getting a wee bit overexcited that she might come home this week, I was reigned in with the conservative estimate of two weeks to go. Aww stink, but YAY! :-) I am trying hard not to think of all the things that could go WRONG and KEEP her there in that time.... but darn it she is truly doing AWESOME!!! Just one big reflux per day lately, everything else has been great. Really praying she doesn't catch any of the bugs going around my house here.... pleeeease breast milk mega-antibodies, do your magic! :-)
Softening the blow of that news was a fun spontaneous visit from my brother who lives in Washington state and happened to be in town on business. He stopped by the NICU to meet Audrey one night during his very short time in town, and we had a nice chat while I gave her a bath.
Awww! We love you Uncle Bob! |
Tuesday, September 6, 2011
Tuesday, September 6
A few of the special people in Audrey's world! Above center, Robyn is our angelic hospital "Auntie" who visited Audrey on some of the days we could not, for the sole purpose of cuddling and playtime. She made a huuuuuuge difference in my guilt level and we are so thankful for her tender attention to our baby girl. Above right, is our fantastic dietician, Cecilia. What an awesome lady. I will miss her! Below center, our sweet friend Angie and her family were our neighbors a few years ago, and this June when she gave birth 16 weeks early to her beautiful baby Charly, we became neighbors again, this time in the NICU. It has been a joy and privilege to share in their family's journey both in person and online at her gorgeous website, charlybella.blogspot.com Below left, our mutual friend Lynn and I attended Charly's baby shower, and then went to visit Audrey that evening, where Lynn filled the NICU with her beautiful singing voice as she sang "A Song For the Mira" to Audrey.
Audrey was delighted with her lullaby serenade from Lynn. She stared at her and couldn't stop smiling, and then her eyes gradually closed, and then after a minute she opened them again to smile at Lynn just one more time, then closed them and slept peacefully.
I wish I had time or the energy right now to write about the past few days, weeks, whatever it is that mush of time since I last updated things, but here's a nutshell update on just the medical stuff: her refluxing is strong but only happening a couple of times a day at the moment, Sunday morning her Picc line went bad so we had to go to a peripheral IV to give her TPN, which made the IVs go bad SUPER fast (like she was getting it replaced within 24 hrs, poor baby!), and today we dropped that yucky TPN at last and she will just get the less caustic part of the TPN through her IV until we finally get her up to full feeds again through her g tube... which hopefully will be in a couple of days. They've been raising the milk amounts faster since the picc went bad, but we are all super concerned that it may be too fast for her stomach to handle. Today was the first time that she has had milk come out of her mouth (and nose) when she refluxed, since right after surgery... but it only happened once today and she was good the rest of the day. She is still on continuous feeds and might even come home that way, because of the concerns over her low blood sugars from a while ago, but so far there hasn't been a chance for us to really see whether her pancreas has improved because she hasn't ever been without a constant stream of sugar coming in, still they are checking her fairly often (poke poke, sad!) but the results are good. Her liver problem has dropped to ONE FOURTH of when we were so scared last week, so that is a huge YAY too. And we also think her voice is sounding much stronger, so we are hoping there is some measurable improvement there too--which would be a step toward mouth feeds! She is still not opening her mouth much at all, but we see tiny improvements almost daily now even with that.... what a beautiful lesson in patience this is!! I just know that having her home is going to give us the time we need to do things at her pace, with all the positive sweet reinforcements she will need to overcome this!
Occupational therapy with Kylie! It still makes me giggle to think that Audrey's "occupation" is pretty much just normal baby stuff, flexing and exercising the right muscles to scoot, and so forth. But watching you could see that Audrey was working hard-- this stuff was pretty difficult for her and she didn't like having to do it, but she looked so good when she did! The gunk on her face is from the hearing test electrodes-- whatever that stuff was, it was really tough to get off without hurting her! I really am so proud of her for enduring so patiently! I think she knows good things are coming!
She's working on getting used to hands by the mouth. Her oral aversion causes her to gag any time something goes past her lips, so we are working on just getting gently used to normal baby things like that. I love that chunky monkey grin!